ALBANY — Hot temperatures have been associated with an increase in heat-related symptoms and even deaths.
Pattern and trend reviews of New York State Office of Mental Health incident reports have confirmed these findings.
Individuals receiving antipsychotic medications are at particular risk of heat stroke and neuroleptic malignant syndrome during periods of extreme heat, which is more likely in poorly ventilated rooms, according to a news release.
Children and the elderly are at increased risk. In addition to monitoring individuals at risk, including any people placed in seclusion or restraints during and after such episodes, prevention is paramount, the release stated.
The news release stated that these conditions may best be prevented by:
– Heightened attention to the state of hydration of patients, particularly those at high risk (those on antipsychotic medications, the elderly, children and those with poor fluid intake)
– Helping high risk patients remain in cooler areas
– Monitoring patients for temperature elevations
– Avoiding direct exposure to sunlight or minimizing exposure
– Wearing protective clothing and using sunscreen
– Minimizing anticholinergic medications which may interfere with sweating, e.g., treating extrapyramidal symptoms with amantadine or other agents approved for the treatment of EPS instead of anticholinergics such as benztropine or trihexyphenidyl
If not recognized and treated early, heatstroke can be fatal. According to the release, the symptoms of heatstroke include:
– Elevated body temperature (Temperature of 104 degrees F is the main sign of heatstroke.)
– Hot and dry skin to the touch (not present in all cases)
– Altered mental status
– Nausea and/or vomiting
– Headache
– Fast heart rate
– Rapid respirations
For patients experiencing significant temperature elevations, where heat stroke or NMS are a consideration, antipsychotic medications should be held until the diagnosis is clear.
If the diagnosis of NMS is confirmed, the release stated the antipsychotic medication must then be discontinued.